Vaping/E-Cigarette Health Risks: What’s the Latest?

  • Vaping THC products can carry much higher risks than vaping nicotine. People should avoid using any vaping products containing THC and be especially vigilant about vaping products from illicit sources.
  • The long-term health effects of vaping products are still unknown.

Medically reviewed by Andy Tan, PhD, MPH

E-cigarettes have grown in popularity in recent years, especially among teens, whose e-cigarette use now exceeds that of traditional cigarettes. With this increase have come growing concerns about the long- and short-term health effects of vaping.

We spoke with Dana-Farber’s Andy Tan, PhD, MPH, who studies how communication strategies influence the use of tobacco products in different populations, about e-cigarettes, the health risks associated with them, and the similarities and differences between cigarettes and e-cigarettes.

What is vaping?

Tan: Vaping refers to the use of e-cigarettes, which heat up a liquid to produce an aerosol that is inhaled by the user. The liquids used in e-cigarettes can contain different ingredients, including:

  • nicotine
  • flavors
  • THC (the chemical responsible for most of marijuana’s psychological effects)
  • CBD (an active ingredient from hemp)
  • and other additives.

It’s important to distinguish vaping nicotine from vaping THC, because they involve very different user groups and can have different effects on health.

What are the major health risks associated with vaping?

Tan: For nicotine, the risks come from the fact that it is a highly addictive chemical, it’s harmful to children and young people because of its impact on brain development, and it’s harmful to pregnant mothers and developing fetuses.

Other health risks derive from the harmful and potentially harmful substances found in many vaping liquids, including:

  • Formaldehyde
  • Particulate matter
  • Heavy metals
  • Volatile organic compounds

Some of these substances have been implicated in heart and lung diseases and cancer.

The long-term health effects of nicotine vaping are still under investigation.

As for THC vaping, it has been linked to 90% of cases of acute lung injury that have occurred in e-cigarette users. THC is a psychoactive substance with a wide range of health effects, some of which can occur with long-term use.

E-cigarette devices are themselves cause for concern. Defective batteries can produce injuries from fires and explosions. There’s also a risk of poisoning from accidental swallowing or skin exposure of e-liquids.

Why have some people died from vaping?

Tan: Based on the latest investigation by the Centers for Disease Control and Prevention, the greatest risk comes from vaping products containing THC, particularly products from illicit sources. The risk may be tied to chemicals added to the e-liquid. A much smaller proportion of cases of vaping-related illness have involved products containing only nicotine.

How do the health effects of vaping compare with the those of cigarette smoking?

Tan: Nicotine vaping products generally contain fewer toxic chemicals, and at much lower levels, than those found in traditional cigarettes. A report by the National Academy of Sciences, Engineering, and Medicine concluded, “There is conclusive evidence that completely substituting e-cigarettes for combustible tobacco cigarettes’ reduces users’ exposure to numerous toxicants and carcinogens present in combustible tobacco cigarettes.”

It also found “there is substantial evidence that completely switching from regular use of combustible tobacco cigarettes to e-cigarettes results in reduced short-term adverse health outcomes in several organ systems.”

Regarding THC vaping, we now know that vaping these products, particularly if they come from illicit sources, is linked to serious lung illness and is potentially deadly. People should avoid using any vaping products containing THC and be especially vigilant about vaping products from illicit sources.

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